Information Collection Request

(CMS-10530) Ambulatory Surgical Center Quality Reporting Program

ICR 201611-0938-019 · OMB 0938-1270 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
CMS-10530 ASCQR PRA Package SS A - Passback3 (Clean).docx Supporting Statement A Uploaded 2017-04-07 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
214868 Ambulatory Surgical Center Quality Reporting (ASCQR) Program Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
04/30/2018 36 Months From Approved 10/31/2017
1,407,576 0 744,816
367,711 0 444,790
0 0 0





Reginfo record details
1
table that charts list of burden
IC Title Form No. Form Name
Ambulatory Surgical Center Quality Reporting (ASCQR) Program

table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 1,407,576 744,816 0 662,760 0 0
Annual Time Burden (Hours) 367,711 444,790 0 -77,079 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No